Skip to main content
Log in

Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Our aim is to evaluate the incidence of unrecognized uterine abnormalities in cases with recurrent IVF failure by screening office hysteroscopy (OH), and impacts of treatment of hysteroscopic findings on the success rate of IVF.

Materials and methods

The retrospective and descriptive study was conducted at assisted reproduction unit in a tertiary medical center. One hundred and fifty-seven patients with a history of recurrent IVF failures underwent hysteroscopy between May 2009 and March 2012. Hysteroscopy (diagnostic or operative, as appropriate) was performed to evaluate the endometrial cavity in patients with two or more IVF failures and Incidence of abnormal hysteroscopic findings and the clinical pregnancy rate (CPR) in subsequent IVF cycles were assessed.

Results

In all, 44.9 % of the patients included in this study had abnormal hysteroscopic findings and 75 women (48.1 %) became pregnant following hysteroscopy. Of these pregnancies, 36 occurred in women with corrected endometrial pathology, the majority of which was identified as endometrial polyps. Implantation rate and clinical pregnancy rate were statistically significant increased after polipectomy.

Conclusion

Abnormal findings on hysteroscopy are significantly higher in patients with previous ART failure and hysteroscopy could be seen as a positive prognostic factor for achieving pregnancy in subsequent IVF procedure in women with a history of RIF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Margalioth EJ, Ben-Chetrit A, Gal M, Eldar-Geva T (2006) Investigation and treatment of repeated implantation failure following IVF–ET. Hum Reprod 21:3036–3043

    Article  PubMed  CAS  Google Scholar 

  2. Alex S, Neri L (2012) Repeated implantation failure: clinical approach fertility and sterility, vol 97, No. 5

  3. Fatemi HM, Kasius JC, Timmermans A, van Disseldorp J, Fauser BC, Devroey P et al (2010) Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization. Hum Reprod 25:1959–1965

    Article  PubMed  CAS  Google Scholar 

  4. Levi Setti PE, Colombo GV, Savasi V, Bulletti C, Albani E, Ferrazzi E (2004) Implantation failure in assisted reproduction technology and a critical approach to treatment. Ann N Y Acad Sci 1034:184–199

    Article  PubMed  CAS  Google Scholar 

  5. Rai R, Regan L (2006) Recurrent miscarriage. Lancet 368(9535):601–611

    Article  PubMed  Google Scholar 

  6. Bohlmann MK, von Wolff M, Luedders DW, Beuter-Winkler P, Diedrich K, Hornemann A, Strowitzki T (2010) Hysteroscopic findings in women with two and with more than two first-trimester miscarriages are not significantly different original research article. Reprod Biomed Online 21(2):230–236

    Article  PubMed  Google Scholar 

  7. Bozdag G, Aksan G, Esinler I, Yarali H (2008) What is the role of office hysteroscopy in women with failed IVF cycles? Reprod Biomed Online 17:410–415

    Article  PubMed  Google Scholar 

  8. Soares SR, Barbosa dos Reis MM, Camargos AF (2000) Diagnostic accuracy of sonohysterography, transvaginal sonography, and hysterosalpingography in patients with uterine cavity diseases. Fertil Steril 73:406–411

    Article  PubMed  CAS  Google Scholar 

  9. Crosignani PG, Rubin BL (2000) Optimal use of infertility diagnostic tests and treatments. The ESHRE Capri Workshop Group. Hum Reprod 15:723–732

    Article  PubMed  CAS  Google Scholar 

  10. Golan A, Eilat E, Ron-El R, Herman A, Soffer Y, Bukovsky I (1996) Hysteroscopy is superior to hysterosalpingography in infertility investigation. Acta Obstet Gynecol Scand 75(7):654–656

    Article  PubMed  CAS  Google Scholar 

  11. Bosteels J, Weyers S, Puttemans P, Panayotidis C, Van Herendael B, Gomel V et al (2010) The effectiveness of hysteroscopy in improving pregnancy rates in subfertile women without other gynaecological symptoms: a systematic review. Hum Reprod Update 16:1–11

    Article  PubMed  Google Scholar 

  12. Bettocchi S, Ceci O, Nappi L, Di Venere R, Masciopinto V, Pansini V et al (2004) Operative office hysteroscopy without anesthesia: analysis of 4,863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc 11:59–61

    Article  PubMed  CAS  Google Scholar 

  13. Siristatidis C, Chrelias C, Salamalekis G, Kassanos D (2010) Office hysteroscopy: current trends and potential applications: a critical review. Arch Gynecol Obstet 282:383–388

    Article  PubMed  Google Scholar 

  14. Rama Raju GA, Shashi Kumari G, Krishna KM, Prakash GJ, Madan K (2006) Assessment of uterine cavity by hysteroscopy in assisted reproduction programme and its influence on pregnancy outcome. Arch Gynecol Obstet 274:160–164

    Article  PubMed  CAS  Google Scholar 

  15. Gaglione R, Valentini AL, Pistilli E, Nuzzi NP (1996) A comparison of hysteroscopy and hysterosalpingography. Int J Gynecol Obstet 52:151–153

    Article  CAS  Google Scholar 

  16. (2004) National institute for clinical excellence guidelines tools to optimize the IVF–ET procedure and its cost effectiveness, RCOG Press, London

  17. Oliveria FG, Abdelmasih VG, Diamond MP, Dozortezef D, Nagy ZP, Abdelmassih R (2003) Uterine cavity findings and hysteroscopy interventions in patients undergoing in vitro fertilization–embryo transfer who repeatedly cannot conceive. Fertil Steril 80:1371–1375

    Article  Google Scholar 

  18. Taylor E, Gomel V (2008) The uterus and fertility. Fertil Steril 89(1):1–15

    Article  PubMed  Google Scholar 

  19. Hossam ES, Mahmoud E, Mostafa K (2012) Eissa routine office hysteroscopy prior to ICSI and its impact on assisted reproduction program outcome: a randomized controlled trial. Middle East Fertil Soc J 17:14–21

    Article  Google Scholar 

  20. Fatma A (2010) Hysteroscopy in women with implantation failures after in vitro fertilization: findings and effect on subsequent pregnancy rates. Middle East Fertil Soc J 15:288–291

    Article  Google Scholar 

  21. El-Toukhy T, Sunkara SK, Coomarasamy A, Grace J, Khalaf Y (2008) Outpatient hysteroscopy and subsequent IVF cycle outcome: a systematic review and metaanalysis. Reprod Biomed Online 16:712–719

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pinar Cenksoy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cenksoy, P., Ficicioglu, C., Yıldırım, G. et al. Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates. Arch Gynecol Obstet 287, 357–360 (2013). https://doi.org/10.1007/s00404-012-2627-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-012-2627-5

Keywords

Navigation